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  • Cameron Oglesby

Dementia isn’t a singular noun. Part 4: Dementia treatments

At the beginning of this series, I mentioned in passing that some conditions with dementia-like symptoms are completely curable.

Vitamin B12 supplements can reverse pernicious anemia. Hormonal supplements can correct hypo- and hyperthyroidism, along with other hormonal imbalances. Antibiotics can fight encephalitis, meningitis, and other brain infections. And selective serotonin reuptake inhibitors (SSRIs) can counter depression symptoms that mimic dementia.

Genuine dementia isn’t curable, however. But its symptoms are treatable, with medications and with therapy. (These medications can have side effects, including nausea, dizziness, vomiting, slowed heart rate, and diarrhea.)

· Cholinesterase Inhibitors – Acetylcholinesterase is important for learning, memory and cognitive skills. In Lewy-body dementia and Alzheimer’s disease, it breaks down. By slowing that breakdown, cholinesterase inhibitors can decrease disorientation, confusion, and memory problems.

· Glutamate Inhibitors – Glutamate overproduction leads to increased brain cell damage and neurodegeneration. Glutamate inhibitors work to treat moderate to severe Alzheimer’s disease by preventing this damage.

· Antidepressants, antipsychotics, and mood-stabilizing medications – Dementia causes mood swings and increases anxiety and agitation; as the name implies, mood-stabilizing meds can reduce those. Dementia also causes depression, which antidepressants can relieve. Stage 6 dementia can bring on hallucinations, delusions, and paranoia, which antipsychotics may be able to relieve. (They can have dangerous side effects, are prescribed only in moderation, and require careful supervision.)

· Cognitive Stimulation Therapy has been clinically proven to help mild to moderate dementia patients. Its memory, language ability, and problem-solving training improves cognitive functioning and increases memory and reasoning skills without medication.

· Behavioral Therapy is twice as effective as antipsychotics for treating anxiety, aggression, depression, wandering, and insomnia. What’s more, there are no side effects, and trained family caregivers can administer it. It involves addressing the triggers or causes of unwanted behaviors and substituting more constructive ones. For example, when feelings of restlessness make a dementia patient want to wander away from home, a trained caregiver can implement an exercise regimen instead.

· Reality Orientation Therapy works to reduce confusion and disorientation with orienting time-and-place information throughout the day.

· Validation Therapy reduces stress and fosters positive communication by discussing and accepting the dementia patient’s ideas and values.

· Montessori-Based Treatment uses the creative activities of Montessori early education to keep dementia patients grounded and delay symptoms from worsening. This helps them actively engage their minds, reconnect with reality, and feel more secure and less angry and frustrated.

A number of management tools can help create a home environment that improves functioning and reduces stress for dementia patients and their families in everyday life.

· External memory aids, whether digital or analog, high-tech or low, can help compensate for lost memory. Alarms that remind patients to take medications, pictures, notes, message boards, and clocks can reduce confusion and disorientation.

· Consistent daily routine – The uniform daily rhythm that a consistent schedule creates gives dementia patients more stability and independence. There may be consistent times of day when patients are more cooperative and less disoriented. These are good times for scheduling important events and activities.

· Stress management – Different people have different stressors and anxiety levels. Experimenting with calming music, exercise, meditation, social interaction, and animal pets can show which techniques work best to relieve those stresses.

· Lower-stress home environment – Loud noises, bad lighting, glare-prone reflective surfaces, and clashing colors and patterns can all agitate and disorient dementia patients. Creating a more peaceful, calming environment reduces these stresses.

No two people are exactly alike – particularly people with dementia.

That’s why there’s no such thing as one-size-fits all senior care – especially when dementia’s involved. It’s why we get to know our clients and their families with a thorough three-part needs assessment, covering everything from physical, psychological and mental status to mobility issues and nutritional needs and legal wishes. Why we custom-design a holistic, coordinated care plan based on each client’s individual needs. And why our monthly nursing assessments involve not just checking vital signs, but carefully tracking not only physical, but also cognitive changes – and updating the caregiving plan accordingly.

Whether for dementia or regular aging, please contact us to see the difference that kind of one-person-at-a-time approach can make.

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